Clinical characteristics and guideline compliance analysis of chronic obstructive pulmonary disease patients with initial triple therapy in real-life world
10.3760/cma.j.cn431274-20220526-00506
- VernacularTitle:现实世界中接受三联吸入药物初始治疗的慢性阻塞性肺疾病患者的临床特征及指南遵循分析
- Author:
Yuqin ZENG
1
;
Wei CHENG
;
Qing SONG
;
Cong LIU
;
Shan CAI
;
Yan CHEN
;
Yi LIU
;
Qimi LIU
;
Zhiping YU
;
Zhi XIANG
;
Xin LI
;
Yingqun ZHU
;
Libing MA
;
Ming CHEN
;
Mingyan JIANG
;
Weimin FENG
;
Dan LIU
;
Dingding DENG
;
Ping CHEN
Author Information
1. 中南大学湘雅二医院呼吸与危重症医学科 中南大学呼吸疾病研究所，长沙 410011
- Keywords:
Pulmonary disease, chronic obstructive;
Administration, inhalation;
Drug therapy, combination
- From:
Journal of Chinese Physician
2022;24(7):976-980
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe the clinical characteristics and guideline compliance of chronic obstructive pulmonary disease (COPD) patients with initial triple therapy in real-life world.Methods:This study is a cross-sectional study. The subjects of the study were COPD patients admitted to 13 hospitals in Hunan Province and Guangxi Zhuang Autonomous Region from December 2016 to December 2021. The initial treatment was triple inhaled drugs. The data collected included gender, age, diagnosis, body mass index (BMI), history of acute exacerbation (AE) in the past year, pulmonary function, COPD Assessment Test (CAT) score, modified British Medical Research Council Dyspnea Questionnaire (mMRC), inhaled drugs and other indicators. The characteristics and differences of COPD patients before and after 2020 were analyzed.Results:7 184 patients with COPD were enrolled in this study, including 2 409 COPD patients treated with initial triple therapy, accounting for 33.5%(2 409/7 184). Taking January 1st, 2020 as the cut-off point, 1 825 COPD patients (75.8%) received initial treatment with triple inhaled drugs before 2020 and 584 patients (24.2%) after 2020 were included in this study. Compared with COPD patients before 2020, the COPD patients after 2020 had higher FEV 1% [(40.9±15.5 )% vs (39.3±15.5)%, P=0.040], lower CAT [(15.8±6.5)point vs (17.5±6.2)point, P<0.001], less AE in the past year [1(0, 2)times vs 1(0, 2)times, P=0.001] and higher rate of non-AE [255(43.7%) vs 581(37.1%), P=0.006]. In addition, before 2020, patients with COPD were mainly treated with open triple drugs (1 825/1 825, 100%); after 2020, 306 patients (52.4%) received open triple inhaled drugs, and 278 patients (47.6%) received closed triple inhaled drugs. Conclusions:In real-life world, most of patients with COPD treated with triple therapy have severe lung function, obvious symptoms and high risk of acute exacerbation. The real-world prescribing of triple therapy in patients with COPD does not always reflect recommendations in guidelines and strategies, and overtreatment is common. After 2020, prescribing triple therapy for COPD patients is more positive and worse consistency with guideline.
